Manipulation Under Anesthesia (MUA) is multidisciplinary manual therapy treatment system which is used to improve articular and soft tissue movement using specifically controlled release, myofascial manipulation, and mobilization techniques while the patient is under moderate to deep IV sedation using monitorized anesthesia care (MAC).

This procedure is used by orthopedic surgeons as a means of breaking up scar tissue around a joint without complete range of motion. In cases of post operative total knee replacement, for example, if a patient is having difficulty achieving their flexibility after a 6-8 week period, the surgeon may elect to bring the patient back to the operating room, place them under anesthesia and perform a manipulation under anesthesia. The procedure takes a relatively short period of time (15- 20 min) and the surgeon can gain improved range of motion for the patient. This can also be performed for other orthopedic musculoskeletal limitations, as indicated. Knee manipulation under anesthesia (MUA) is indicated for total knee arthroplasty (TKA) patients who have not obtained at least 90° of flexion by the 6th postoperative week.